A trio of changes to an academic rheumatology clinic’s electronic health record (EHR) improved the capture of patients’ rheumatoid arthritis (RA) disease activity scores and increased physician satisfaction, but they stopped short of yielding similar gains in disease activity levels. Researchers published their findings in the journal Arthritis Care & Research.
“Applying treat-to-target strategies in the care of patients with RA is critical for improving outcomes,” the researchers wrote, “yet, EHRs have few features to facilitate this goal.”
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The study looked at the effect of 3 health information technology initiatives implemented to improve outcomes: an EHR flowsheet to input Clinical Disease Activity Index (CDAI) scores, peer performance reports, and an EHR “smart form” that included a CDAI calculator.
Between 2012 and 2017, electronic capture of CDAI scores grew from 0% to 64%, the researchers reported. After the implementation of the smart form, physician satisfaction grew, too.
Nevertheless, researchers did not observe any meaningful changes in disease activity levels during the study period.
“This study illustrates how a series of health information technology initiatives can evolve to enable sustained changes in practice,” they wrote. “However, capture of RA outcomes alone may not be sufficient to improve levels of disease activity without a comprehensive treat-to-target program.”
Gandrup J, Li J, Izadi Z, et al. Three quality improvement initiatives and performance of rheumatoid arthritis disease activity measures in electronic health records: results from an interrupted time series study. Arthritis Care & Research. 2020;72(2):283-29. doi:10.1002/acr.23848